Your Med Cabinet

Specialties School

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My SW texted me today around 4:30, after work, and said that one of the 10th grade girls, who was staying after school for theater practice, had anxiety and could he give her an Ativan.

She gets Ativan 0.5mg prn anxiety. She started the year with 10 pills, she has about 4 left. She took one yesterday, and I know she has increased anxiety about the play.

I do not doubt for one second that she wanted/needed the Ativan.

I do trust the SW.

I told him no. I would not let him administer her the meds, nor would I tell him where the keys to the cabinet were. I told him to call her mom, or that I would, and have her come get or medicate her daughter. He did not press, then later texted me and said she got through it.

I feel like I was right. Was I right?

Flare, ASN, BSN

4,431 Posts

Specializes in school nursing, ortho, trauma.

Iam guessing your state's laws are not unlike mine (nj). And yes, you are right, the sw can not admin the medication unless by some chance that sw also happens to have a nursing license. I would have made the exact same call.

kidzcare

3,393 Posts

Help me out... What is SW?

Help me out... What is SW?

social worker I assume

I would have made the same call as well.

ohiobobcat

887 Posts

Specializes in ED, School Nurse.

SW = social worker (I think!)

If your social worker is not trained to administer medication, then absolutely you made the right call.

I looked in the rules for my state and couldn't find anything about trained unlicensed personnel administering medication after school hours.

kidzcare

3,393 Posts

social worker I assume

Makes sense... Thanks!

In IL, only an administrator can give medication in my absence (or a teacher with an administrative degree). It turns into a whole big issue when the kids go on field trips.

But with PRN ativan... that takes an assessment to determine whether or not it should be given. I vote no.

Specializes in School nursing.

See for me a PRN means eval, equaling a nursing judgement. I also have PRN Ativan for a couple of students and do not delegate that to unlicensed personal. I've talked to the parents of said student about that policy and they actually really appreciated it, believe it or not!

Farawyn

12,646 Posts

Thank you all. The best part of this thread- even in our autonomous job, we are not alone.

ohiobobcat

887 Posts

Specializes in ED, School Nurse.

I agree that PRN = nursing judgement.

However, I just read through my state laws again and saw no exclusion for PRN medications administered by unlicensed personnel. Not every school has a nurse present all the time. With proper training and documentation, unlicensed personnel can administer PRN medication. This has to be the case in some schools. Otherwise students who need PRN meds, say for anxiety, have to wait until a nurse is present before they can be medicated? That's not always plausible, nor beneficial for the student. How does this work, for those school nurses who cover more than one school, or who are part-time?

The law in my states actually includes provisions for "Special Activities" which I imagine after school activities would fall under.

I still think Farawyn was right not to allow the SW to administer the medication. My wheels are spinnin' with all these different scenarios, though. :)

bsyrn, ASN, RN

810 Posts

Specializes in Peds, School Nurse, clinical instructor.

You absolutely did the right thing :)

Wave Watcher

751 Posts

Specializes in Community Health/School Nursing.

We do not give prn behavioral/anxiety drugs in our district. One reason is many teachers would rather medicate than educate if there is a behavioral problem with a student in our district.

We do give meds for add/adhd if it is required at lunch time and is a scheduled medication for 3x a day.

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